| NPI | 1679667463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0101281511) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 47823-020) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 247436-01) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2024-02-26 |